the fact that laparoscopy, in addition to its cosmetic advantages, also
tends to result in lower recurrence rates and less chronic pain than
open repairs, we're seeing a resurgence in tissue-based open inguinal
hernia repairs.
Why have non-mesh repairs, like vinyl records, suddenly become a
thing again? Because laparoscopy necessitates the use of mesh — and
the public backlash against mesh has been fervent. Mesh and mesh-
related complications are generating a lot of bad publicity, driven
mostly by the failure of transvaginally placed mesh for urinary inconti-
nence. Unfortunately, many patients are confusing hernia mesh out-
comes with transvaginal mesh outcomes.
The issue is complicated by the fact that there have been quite a few
mesh-related complications for hernias, especially inguinal hernias.
There just haven't been nearly as many as patients have been led to
believe. So, now a great many voices out there are completely anti-
mesh: It's terrible! It should be banned! To add to their frustration,
we have surgeons who don't hear their cries. They're adamant that
mesh works, it's the standard of care and we should implant it in
everyone. I am very in tune with these issues. I see firsthand that
many are hurt and angry about mesh on herniatalk.com, the free
patient-surgeon discussion board I moderate.
Non-mesh repairs
Non-mesh repairs were the standard well before any of us were born.
Whereas once upon a time it was the norm for general surgeons to
graduate from general residencies without ever seeing — let alone
doing — open-tissue repairs for inguinal hernias, more and more sur-
geons are now trying to differentiate themselves by offering non-mesh
open repairs.
I'm offering more non-mesh repairs than I used to. To add to the
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